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NPI Code Detail

MEDICARE: ALICIA G TOBLER CNM

MEDICARE: ALICIA G TOBLER CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse041.373526IL
2367A00000XAdvanced Practice Midwife209.007448IL

General Provider Information

NPI Number : 1427280478
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA G TOBLER CNM
Provider Business Mailing Address
First Line : 1817 S LOOMIS ST
Second Line :
City : CHICAGO
State : IL
Zip : 60608-3018
Country : US
Telephone Number : 312-666-6511
Fax Number : 312-666-1658
Provider Business Practice Location Address
First Line : 1817 S LOOMIS ST
Second Line :
City : CHICAGO
State : IL
Zip : 60608-3018
Country : US
Telephone Number : 312-666-6511
Fax Number : 312-666-1658
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2009
Last Update Date : 06/07/2012

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Directions to “ ALICIA G TOBLER CNM” Practice Location

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